The state of Rio de Janeiro has the highest mortality rate from tuberculosis, according to data from the Oswaldo Cruz Foundation (Fiocruz). In 2022 alone, the coefficient was five deaths per 100 thousand inhabitants and the incidence rate of 68.6 cases per 100 thousand inhabitants, alarming numbers considering the territorial dimension of the state. Experts believe that this reflects the complex socio-economic situation of the residents.
The manager of tuberculosis at the State Department of Health in Rio, Marneili Martins, explains that there are many points that contribute to the advancement of the disease, but the first is social vulnerability.
“We have a very complicated population density in the state of Rio and this favors and increases the risk of the disease in communities. This is a very serious factor that we health professionals are unable to resolve on our own. We need the support of civil society, intersectoral, intersectoral support, we need education, housing, a set of secretariats to help us”.
Also read: “Indigenous peoples did not declare themselves as such as a survival strategy”, says anthropologist
According to Marneili, public health policies need to be built to ensure that people are diagnosed right at the onset of symptoms.
“When no one identifies this case at the end, they arrive at our hospitals, where they weren’t supposed to arrive, they weren’t supposed to be in a hospital. So he ends up arriving seriously, thinking he has pneumonia, but he has had those symptoms for months and will only be identified in an emergency, ”he explains.
The family and community physician, Eberhart Portocarrero Gross, who works at the family clinic in Rocinha, a neighborhood in the south of Rio, explains that housing conditions greatly influence the risk of tuberculosis contamination.
“It doesn’t mean that a rich person can’t have tuberculosis, but it does mean that it grows in poorly ventilated places, places with many people in the same room. If we don’t look at urbanism, think about the ventilation of houses, if we don’t look at education so that people understand the need for treatment, if we don’t look at economic conditions, living conditions, family members, these things add up and make a treatment difficult, which in itself is already complicated”, says the doctor.
For Eberhart, there is a lack of will on the part of the responsible bodies to promote more studies to reduce the duration of tuberculosis treatment. He explains that because it is very long with an average of six months taking antibiotics, many people end up interrupting halfway through.
“There is a chance that it will be reduced, there are researches saying that tuberculosis treatments would achieve a cure in 4 months, 3 months, but these researches advance very slowly because the social weight, the degree of financial investment and political implication ends up not being so great as for other things”.
The search for partnerships between government agencies, non-governmental organizations and civil society is essential for the implementation of effective and sustainable policies to combat tuberculosis in the state. The researcher from the Oswaldo Cruz Foundation (Fiocruz), André Pereira Neto, points to another factor that contributes to the increase of the disease in the state: wrong information about the number of weeks of cough that the patient needs to wait to see the doctor.
“Quality information saves lives, or it can save lives or it can prevent death. The website of the Ministry of Health and the Health Secretariats of Brazil insist on disclosing that it is three weeks, when in fact it is two weeks and in fact what the WHO says is that it is not just the cough but a set of other symptoms, this information is essential. For me, one of the things that lead to this large number of people with tuberculosis in Brazil and especially in Rio de Janeiro is that information and communication for the health departments and the ministry is a minor thing”, he concludes.
The protocol released by the Ministry of Health explains that the duration of the cough to identify the disease “takes into account the risk of illness and the population’s access to care, often favoring the opportunity to carry out the diagnostic examination to the detriment of the duration of the cough ”.
Source: BdF Rio de Janeiro
Editing: Mariana Pitasse